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ARCHIVED REPORTS XR0006101
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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1876
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2900 - Site Mitigation Program
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PR0542421
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ARCHIVED REPORTS XR0006101
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Entry Properties
Last modified
6/21/2019 12:33:50 PM
Creation date
6/21/2019 10:29:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006101
RECORD_ID
PR0542421
PE
2950
FACILITY_ID
FA0024377
FACILITY_NAME
COUNTRY CLUB BLVD/295950
STREET_NUMBER
1876
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12319101
CURRENT_STATUS
01
SITE_LOCATION
1876 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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} <br /> 720 Olive Drive,Suite D <br /> .�� Davis,CA 95616 � <br /> Lab 530 297 4800 ' <br /> ANALYTICAL LLC Fax 530 297 4808 Lab No Page os- <br /> �J— <br /> Project Contact(Hardcopy or PDF To) California EDF Report? ® Yes ❑No Chain-of-Custody Record and Analysis Request <br /> 11iV <br /> Company/Address Reowunandedbut riot to thissecftL H <br /> '^ ' Sampling Company Log Code .�. Analysis Request rQ- <br /> Phone No FAX No Global ID _ m <br /> C3 0 UJ <br /> ProjedNumber P 0 No FDF Deliverable To(Rmaii Address) - S, o ,� c <br /> W o <br /> Project Nam Sakti ler Signature W 0 0 W m $ <br /> f 'J p r m O _N <br /> Protect Address s' ,! Sampling Container Preseryfive Matrix m 22 5 t t � 1 Ot (0 o <br /> � �f f%✓�/ Q n r o m m c a m m z LL <br /> /-✓N is!j ��? O W c a N C c c y r$ 2 e iv <br /> J > e•l w 1Li m N i W F CV m C <br /> LU z h v v <br /> m m QD <br /> a r p J U Z v 0 Q 0 a 0= a 0 0 0 m a o m N <br /> Sample Designation Date Time a u, s z _ z cn m m r m <br /> 1167 <br /> 64 <br /> . a <br /> ' ZQlks <br /> Relinquished by D to Time Received by Rema <br /> Relinquished by , Date Time Received by <br /> Relinquished by ©Date <br /> Time Receded Dy La ptoryAg <br /> f _y ill to <br /> Disinbution White-Lab,Yellow-File,Pink-Odgmator Formsfcoc 121001 fh9 <br />
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